incontinence occurring in combination with detrusor overactivity.
incontinence occurring in the absence of urgency.
incontinence associated on coughing in association with urgency and demonstrable detrusor overactivity.
incontinence occurring on coughing in the absence of urgency and of urgency incontinence and with no demonstrable detrusor overactivity.
incontinence that is demonstrated during a cough on clinical examination.
is carried out laparoscopically as effectively as via an open approach.
works by restoring the same mechanism of continence that was present before the onset of incontinence.
is an effective approach for primary intrinsic sphincter deficiency.
aims to improve the support to the urethrovesical junction and correct deficient urethral closure.
is the most effective form of anti-incontinence surgery.
coexisting medical morbidity.
most likely present in the majority of women presenting with SUI.
present only in 30% of patients presenting with SUI.
clearly defined in the current literature.
an absolute contraindication to a retropubic suspension procedure.
accurately identified on the basis of Valsalva leak point pressure.
Strengthening the pubourethral ligaments
Elevating the anterior vaginal wall and paravesical tissues toward the iliopectineal line
Re-creating the normal continence mechanism.
Anchoring the obturator internus fascia to the iliopectineal line
Suspending the bladder onto the periosteum of the symphysis pubis
Having follow-up data of at least 6 months’ duration
Using objective urodynamic-based outcome criteria
Achieving complete continence
Identifying the degree of improvement in the urethral closure pressure
Improving symptoms from the patient’s perspective
A patient who frequently generates high intra-abdominal pressure due to a chronic cough
A patient who needs a concomitant hysterectomy that cannot be performed vaginally
A patient with limited vaginal access
A patient with inadequate vaginal length or mobility of the vaginal tissues
A patient with urethral descent with straining and SUI
The retropubic space must be drained after the procedure to prevent bleeding.
Nonabsorbable sutures are better than absorbable sutures for retropubic suspension procedures.
It is important to avoid dissecting the old retropubic adhesions from prior incontinence procedures because these may contribute to continence.
It may be necessary to open the bladder to facilitate identification of the bladder margins and bladder neck.
A urethral Foley catheter is preferred for bladder drainage because it is more comfortable and associated with fewer urinary tract infections and earlier resumption of voiding.
The sutures should incorporate a full thickness of the vaginal wall and lateral urethral wall.
It carries little risk of causing urethral obstruction.
It is associated with osteitis pubis.
It is important to elevate the midurethra and external sphincter in particular.
A better than 90% cure rate can be expected in the long term.
The repair is performed between the vagina and the arcus tendineus fasciae pelvis bilaterally.
It is less effective than a tension-free vaginal tape procedure.
It is appropriate only for patients with adequate vaginal mobility and capacity.
It is less effective than a paravaginal repair.
It is more effectively performed via a vaginal approach.
it is associated with shorter hospitalization and recovery times.
it is technically simple to perform.
it is more effective than an open colposuspension.
it provides access for repair of an associated central defect cystocele.
it is associated with shorter operating times.
postoperative voiding difficulty.
genitourinary tract fistulae.
detrusor sphincter dyssynergia.
may be due to detrusor sphincter dyssynergia.
is more likely if there is preexisting detrusor dysfunction.
is most likely to occur with undercorrection of the urethral axis.
occurs in less than 1% of patients.
should be managed by urethrolysis within 1 month.
New-onset DO after a suspension procedure performed for stress urinary incontinence invariably resolves within 3 months.
A history of voiding symptoms and new-onset storage symptoms as well as a retropubically angulated urethra usually suggests obstruction.
Preoperative DO is a contraindication to a retropubic suspension because it increases the risk of postoperative DO.
DO occurs de novo, on average in less than 2% of the patients reported in the literature.
DO is not causally related.
is rarely associated with a central defect cystocele.
will be prevented by a synchronous hysterectomy.
occurs only rarely after a paravaginal repair.
results in genitourinary prolapse as a sequel to Burch colposuspension to occur in less than 10% of women.
may aggravate posterior vaginal wall weakness, predisposing to enterocele.
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